TOPLINE:

Food-induced anaphylactic reactions in children at preschools and schools were often severe, involved children with a known allergy to the culprit food (most commonly peanut), and were associated with the underuse of adrenaline.

METHODOLOGY:

• Researchers analyzed data from 3450 cases of food-induced anaphylaxis in pediatric patients (< 18 years) recorded in a European registry from 2008 to 2023 to compare cases that occurred in preschools and schools with those that occurred outside educational settings.
• They collected information such as history of allergies, culprit food, symptoms, and treatments.
• Severity of reactions was graded 2-4 using the Ring classification system, with higher grades indicating more severe reactions.

TAKEAWAY:

• A total of 332 cases (9.6%; median age, 4 years; 63% boys) occurred in preschool or school settings. Most reactions (63.0%) were of grade 2, 36.1% were of grade 3, and 0.9% were of grade 4, including one death.
• Cases that occurred in educational settings were more likely to have a known allergy to the culprit food than those that occurred outside educational settings (45.5% vs 32.4%; P < .001).
• Peanut was the most common triggering food in cases that occurred in educational settings (27.4%), followed by hazelnut (12.7%) and cow’s milk (9.4%).
• Adrenaline was used less often for cases inside vs outside educational settings (16.4% vs 32.1%; P < .001). Only 5.9% of children with food-induced anaphylaxis in educational settings received adrenaline at school, whereas antihistamines and corticosteroids were used more often.

IN PRACTICE:

“Keeping children with food allergies safe in educational settings also requires a collaborative effort among families, healthcare providers, preschool-school and canteen staff, patients’ organizations, industrial catering societies, and policymakers,” the authors of the study wrote.

SOURCE:

Guillaume Pouessel, MD, Children’s Hospital, Roubaix, France, was the corresponding author of the study, which was published online on June 10 in Pediatric Allergy and Immunology.

LIMITATIONS:

The NORA registry may have captured only a small proportion of anaphylaxis cases that occurred in preschools and schools. Most cases came from three countries, limiting generalizability. Researchers lacked information on why adrenaline was not used and when it was given.

DISCLOSURES:

The study received support from NORA e.V. Two authors reported providing consultation and speaker services and serving as medical advisors for commercial companies in the allergy, biotechnology, pharmaceutical, and related sectors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.